SCREENING FOR OCULAR TOXICITY IN ASYMPTOMATIC PATIENTS TREATED WITH TAMOXIFEN

Tamoxifen is an antiestrogen drug used in the treatment of patients wi th breast cancer that is being studied for use in patients at high ris k for developing breast cancer. Case reports have documented ocular to xicity caused by tamoxifen in patients with visual symptoms. We attemp ted to determine the prevalence of ocular toxicity in visually asympto matic tamoxifen-treated patients. We performed extensive ocular examin ations on 135 visually asymptomatic tamoxifen-treated patients. Two pa tients (1.5%) had intraretinal refractile crystals consistent with tam oxifen retinopathy. Both patients were without visual symptoms or visu al loss. Corneal crystals, macular edema, and optic nerve changes were absent. The cumulative tamoxifen doses of these two patients were 10. 9 and 21.9 g, respectively. For the 135 patients studied, the mean cum ulative dose was 17.2 g, with a standard deviation of 13.0. We do not believe the relatively uncommon finding of tamoxifen-related ocular to xicity merits special screening for such disease.